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TMA Physicians Medicaid Congress Action Center

TMA’s Physicians Medicaid Congress is working to make Medicaid work better for those who currently rely on the program or may in the future. At the top of the list are competitive physician payments, mitigating the dual-eligible physician payment cut, and stopping the OIG witch-hunts. We know there are many more improvements, specifically ways the state could simplify and streamline administrative and paperwork requirements.

The Congress wants to hear from physicians and their office managers on practical changes to make the system better, such as asking Medicaid to recognize certain billing modifiers or to streamline paperwork. The Congress is using your ideas to ask for legislative and regulatory changes to Medicaid.

Who makes up the Congress?TMA Physicians Medicaid Congress consists of representatives from TMA’s Select Committee on Medicaid, CHIP and the Uninsured, Border Health Caucus, and specialty societies.TMA President, Michael Speer, MD, and John Holcomb, MD co-chair the Congress.

The ProblemMore than 4 million low-income Texans currently rely on Medicaid for their health care coverage. The vast majority of these patients live in families earning less than 100 percent of poverty, or roughly $20,000 a year for a family of three. These are people we all know or meet in our daily lives – teachers’ aids, bus drivers, hospital orderlies or their children – and patients we care for in our offices, hospital or emergency department.

The vast majority of Medicaid beneficiaries does not have access to employer-based health insurance or cannot afford it if they do. If Texas ultimately decides to implement Medicaid expansion as authorized by the Patient Protection Affordable Care Act, then another 1.5 million to 2 million more low-income Texans will be eligible for Medicaid.

Progress MadeTMA-Backed Law Prompts Medicaid Red-Tape ReliefApparently, the state got the message loud and clear: Physicians and patients are overly frustrated with the myriad administrative roadblocks that came along with the expansion of Medicaid managed care in Texas. Thanks to TMA's advocacy during the 2013 legislative session and the successful passage of Senate Bill 1150, relief from Medicaid red tape may finally be in sight.